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Thread: Malaria Claims

  1. #76
    Moderator DeV's Avatar
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    There are 3 anti-malaria drugs licenced by the HPRA (replaced the IMB):

    Larium
    http://hpra.ie/img/uploaded/swedocum...ved.140604.pdf

    Malarone (similar side effects to Lariam):
    http://hpra.ie/img/uploaded/swedocum...PIL.131106.pdf

    Doxycycline (may cause infections that can't be treated with antibiotics, sun sensitivity, can't lie down for 30 mins after taking):
    http://hpra.ie/img/uploaded/swedocum...1pl.140714.pdf
    Last edited by DeV; 16th April 2015 at 14:08.

  2. #77
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    i and most of my friends have been using Lariam for years on our deployments, it still meets UK Public Health guidelines, can't say i've seen too may side effects in any of us over the **** off ya bollix he said it years.
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  7. #80
    Moderator DeV's Avatar
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    Did a bit of digging.

    Of all the countries the DF is/has deployed to, the CDC recommends (each of the 3 can be used in every AO):
    Mefloquine (Lariam)
    Doxycycline
    Atovaquane & Proguanil (Malarone)

    We know the side effects of Lariam - we want to stop using it

    Malarone can't be prescribed for longer than 28 days - so that is out

    That leaves Doxycycline.

    Doxycycline means no diary, it must be taken while sitting/standing and you can't lie down for 15-30 mins after taking. It can cause stomach upsets and sun sensitivity.

  8. #81
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    Which means it cannot be used in areas where strong sunlight is the norm, such as any desert operation...

  9. #82
    Moderator DeV's Avatar
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    Quote Originally Posted by na grohmití View Post
    Which means it cannot be used in areas where strong sunlight is the norm, such as any desert operation...
    Which leads back to Larium?!

    As malaria areas, where there are PSOs, are normally hot sunny places

    In less of course, the HPRA takes a look at the long term use of Malarone (as others have)
    Last edited by DeV; 10th September 2015 at 21:20.

  10. #83
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    Doxies were used I Timor Tha was pretty sunny

  11. #84
    Moderator DeV's Avatar
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    Not sure about in the past Malarone but the HPRA and Public Health England only licence it for use for up to 28 days.

    It has been tested (and authorised) by other countries but it really is up to the HPRA.
    Last edited by DeV; 17th September 2015 at 04:46.

  12. #85
    Moderator DeV's Avatar
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    PHE has recently licenced Malarone for use for up to a year

  13. #86
    Moderator DeV's Avatar
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    Have done some research on dosage and cost (what the HSE will pay a pharmacy so obviously the DF could get it cheaper but it will give an idea.

    Lariam - weekly dose for 3 weeks prior, for 26 weeks in area and 4 weeks after - total cost € 71.86
    Doxycycline - daily dose for 2 days prior, for 182 days in area and 4 weeks after - total cost € 52.74
    Malarone - daily dose for 2 days prior, for 182 days in area and 1 week after - total cost €502.33


    Sources:
    https://www.gov.uk/government/upload...ines_FINAL.pdf
    http://www.hse.ie/eng/staff/PCRS/items/

  14. #87
    Moderator DeV's Avatar
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    Of course a generic Malarone is available for less than €250

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    And how is Malarone when used in areas with strong sunlight?

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    I used in Nigeria for 3 weeks with no ill affects. 8 years earlier I used Larium for a shorter period in Ethiopia and I went a bit mad.

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  19. #90
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    http://pdforra.ie/news/?p=1178

    This says DF policy is out of line with UN policy but then says Lariam is the UN drug of first choice???

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    Lariam should be drug of last resort for troops, MPs say

    More on the BBC earlier this week about Lariam use in the British Army

    http://www.bbc.co.uk/news/uk-36361374

    Lariam should be drug of last resort for troops, MPs say

    Anti-malarial drug Lariam should be the "drug of last resort" for UK troops, MPs on the defence committee have said.

    The drug has been prescribed to at least 17,000 service personnel at least once between April 2007 and March 2015.

    The MPs criticised the MoD over the way it issued the controversial drug, which can cause severe side-effects, including depression and anxiety.

    The MoD said the "vast majority of deployed personnel already receive alternatives to Lariam".

    Lariam - the brand name for mefloquine - is prescribed to civilians as well as troops.

    While it is not the main anti-malarial drug used by the armed forces, critics argue its side-effects can be more detrimental to those serving in challenging and dangerous countries.

    Malaria is a mosquito-borne infectious disease which causes fever, headaches, vomiting and diarrhoea and can be fatal.

    In 2015, it killed about 438,000 people and there were 214m cases of the disease, mostly in sub-Saharan Africa, according to World Health Organization estimates.

    'Mass deployment'

    After a six-month inquiry, the defence select committee found the potential side-effects were clearly highlighted by manufacturers Roche, but there was "strong anecdotal evidence" that the stringent conditions laid down for prescription were often disregarded.

    Committee chairman Dr Julian Lewis said: "It seems quite clear that not only is the MoD unable to follow the manufacturer's guidelines for prescribing the drug in all instances, but a number of troops discard their Lariam rather than risk its potentially dangerous side-effects.

    "It is our firm conclusion that there is neither the need, nor any justification for continuing to issue this medication to service personnel unless they can be individually assessed, in accordance with the manufacturers' requirements.

    "And most of the time that is simply impossible, when a sudden, mass deployment of hundreds of troops is necessary."

    Lt Col Andrew Marriot: "I haven't had a full night's sleep since 2002"
    'Mad Monday'

    The drug's use had had " absolutely devastating psychological effects" in a small minority of cases," he told the BBC's Today Programme, and: "In a larger minority of cases there are disturbed nights, damaged sleep, psychological ideas that are unsettling and dangerous."

    "In reality the whole experience has been deeply unpleasant. So much so that phrases like 'mad Monday' or 'crazy Tuesday' are used amongst the armed forces when this stuff has been doled out in the past."

    The inquiry came after BBC Radio 4's Today programme revealed that a senior military medic had called on ministers to prescribe an alternative drug until it was clear that Lariam was safe.

    'I kept thinking about hanging myself'

    Maj Mick Wallace took Lariam during his deployment in Kenya in 1998, and he says he has been severely depressed ever since:

    "When I came back my wife said I wasn't the same man. I was short-tempered, anxious at times. I just didn't feel right and it's still going on.

    "I've had several courses of anti-depressants and all they do is stick a plaster over it and as soon as I stop taking them, I go downhill again.

    "I've never attempted suicide but it's been at the back of my mind.

    "Recently I went into my barn which I use as a workshop and I had to leave straightaway because I kept thinking about hanging myself.

    "So many men and woman have already been affected. I think the government would be foolish not to take up the recommendations but this should have happened a long time ago."

    According to MoD figures, a minimum of 17,368 armed forces personnel were prescribed Lariam at least once between 1 April 2007 and 31 March 2015.

    Over the same time period, approximately 104,000 personnel were given a different anti-malarial drug, such as Malarone and Doxycycline.

    As at August 2015, mefloquine constituted only 1.2% of all anti-malaria tablets held and, in terms of doses for a six-month deployment, only 14% of the stock, the MoD said.

    It is not clear how many service personnel have suffered after taking Lariam but according to retired Lt Col Andrew Marriott, who gave evidence to the inquiry, between 25% and 35% of personnel who had been prescribed Lariam on deployment experienced side-effects.

    Some of those affected are contemplating legal action against the MoD.

    Philippa Tuckman, from Hilary Meredith Solicitors, said more than 450 personnel had come forward since late last year, saying they had been affected.

    Roche said it agreed with the defence committee's report and it would continue to work with the MoD "to ensure they have all the relevant information to ensure Lariam is prescribed appropriately".

    The MoD said it would consider the report's recommendations and respond in due course.

    "The vast majority of deployed personnel already receive alternatives to Lariam and, where it is used, we require it to be prescribed after an individual risk assessment," a spokeswoman said.

    "We have a duty to protect our personnel from malaria and we welcome the committee's conclusion that, in some cases, Lariam will be the most effective way of doing that."

    Lariam - 'Not a first-line drug'

    By Michelle Roberts, BBC News website health editor

    Malaria is a serious illness and can be fatal. Drugs can reduce the risk of malaria by about 90%.

    The MoD says Lariam is an important anti-malarial tablet within its portfolio, but it is not the only one.

    The exact choice of drug offered to military personnel depends on "a number of factors", including the region the individual is deploying to, their health and any past history of side-effects.

    There is no single anti-malarial that is effective against all the different possible strains of infection.

    Arguably, all drugs can have unwanted effects, but soldiers have been reporting some particularly nasty ones with Lariam - depression, nightmares, hallucinations and suicidal thoughts.

    The MoD says it only provides soldiers with Lariam when it is necessary and after an individual risk assessment, in line with advice given by the Advisory Committee on Malaria Prevention.

    It says Lariam is not a "first-line drug" and is used primarily when other drugs would either not be effective or appropriate.
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  22. #92
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    http://www.marinecorpstimes.com/stor...tudy/88528568/

    Malaria drug causes brain damage that mimics PTSD: case study

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    http://www.rte.ie/news/2016/0915/816884-lariam/

    It has emerged that the drug manufacturer Roche took Lariam off the market in this country on 31 July. It remains available in other jurisdictions.
    However:-

    A Department of Defence statement said the Defence Forces were made aware by Roche Products Ltd that Lariam was being taken off the Irish market but the drug is still available to them via two main wholesalers.

    The statement says there are no plans to withdraw Lariam from the range of anti-malarial medications they use.
    I can only imagine that the fear is that to stop issuing Larium would be seen as an admission that there's a problem with it.

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  25. #94
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    Quote Originally Posted by terrier View Post
    http://www.rte.ie/news/2016/0915/816884-lariam/



    However:-



    I can only imagine that the fear is that to stop issuing Larium would be seen as an admission that there's a problem with it.
    I think you are spot on Terrier.

    The sickening thing is- Why are the Department willing to risk the physical and mental health of our troops by issuing lariam, in particular when the manufacturer no longer sells it here, simply to help defend legal actions by our troops whose physical and mental health were affected by the Departments use of lariam.
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  27. #95
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    Lessons learnt from the Army deafness claims, while at the same time learning nothing at all from it?
    Well, there's good news and bad news. The bad news is that Neil will be taking over both branches, and some of you will lose your jobs. Those of you who are kept on will have to relocate to Swindon, if you wanna stay. I know, gutting. On a more positive note, the good news is, I've been promoted, so... every cloud. You're still thinking about the bad news aren't you?

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  29. #96
    Moderator DeV's Avatar
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    Quote Originally Posted by na grohmití View Post
    Lessons learnt from the Army deafness claims, while at the same time learning nothing at all from it?
    Have any of the claims been settled yet?

  30. #97
    Moderator DeV's Avatar
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    Important (from a DoD point of view):

    Roche have chosen to stop marketing Larium in Ireland

    It is still legal to sale and prescribe in Ireland

  31. #98
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    Quote Originally Posted by DeV View Post
    Important (from a DoD point of view):

    Roche have chosen to stop marketing Larium in Ireland

    It is still legal to sale and prescribe in Ireland
    Yes it is, but with cases pending the continuing use of it has a whiff of Paddy Powers about it. If the DoD win, then it goes away ; if the Dod lose then the floodgates could open in terms of claims.

  32. #99
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    Read somewhere it is now the drug of last resort with the BA

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    There's more :-

    http://www.irishtimes.com/news/crime...medium=twitter

    [QUOTE]The Defence Forces has not been screening military personnel properly before prescribing the controversial anti-malaria drug Lariam, despite the Government’s claims to the contrary, a support group for soldiers has said.
    The Action Lariam group said new cases of serving and former personnel suffering ill effects after taking the drug, up to and including suicidal ideation, were continuing to emerge.

    It insisted changes to how the drug was being prescribed to military personnel in Britain had no bearing on its use here, adding there were no plans to stop using Lariam in the Defence Forces or to change the way it was being prescribed.
    “The choice of medication for overseas deployment for both officers and enlisted personnel, including the use of Lariam, is a medical decision made by the medical officers in the Defence Forces,” the department said in a statement.[/QUOTE

    How and ever, I was told by someone who ought to know that Larium isn't being issued any more and hasn't been for a while !

    So, armed with this tidbit I went back to the original story on the RTE website, and looked at the DF statement again.

    They are quoted as saying..

    The statement says there are no plans to withdraw Lariam from the range of anti-malarial medications they use.
    So they're not saying that they're actually still issuing it, are they ?

    Curiouser and curiouser .

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